Resource Center. Investigation Areas

Transcription

1 Investigation Areas Depth Study: Re-Phasing The Project is a Phased project. The main focus of this analysis is rephasing the project with ICRA requirements in mind. I am looking to reduce the cost of these ICRA requirements by re-phasing the project. Currently the project is a three-phase project with all phases being Class III. With my analysis I am going to make the project a two-phase project with one phase remaining Class III while the other will be reduced to a Class II. This will allow for both a cost savings and a schedule reduction. When rephasing the project I also took into account hospital operations and activities as well as minimizing disruptions. Infection control has become a very important issue in the renovations of hospitals and other healthcare facilities. Some patients with weakened immune system have a high death rate when they come into contact with certain bacteria. The cost of the ICRA steps is very minimal to the costs that would be inferred due to the lost of a life of a patient at the hospital. Infection Control Risk Assessment Since the project is a renovation of an existing hospital, infection control becomes a major concern of the project. Most patients are very susceptible to disease due to their weakened immune systems. Steps must be taken to ensure that these patients are not affected by the construction taking place in areas of the hospital. They can t be coming in contact with the air-borne dust or other air-borne bacteria generated from the construction activities. There are special regulations that all hospital renovations must follow to ensure the patients safety. The Department of Health (D.O.H.) has established an Infection Control Risk Assessment (ICRA) rating that is used on all hospital renovations. This rating determines the amount of precautions that must be taken due to a number of circumstances. The area of the hospital where the construction is to take place, the type of patients in the area, and the type of construction activities determines the rating class assign to the renovation. Once the class of the project is determined there are certain regulations that must be completed for each class of project. These regulations require certain precautions to be completed before construction can start, during construction, and when construction is complete. ICRA Class and Precautions There are four different classes that a project can be. The higher number the project the more steps that must be taken to ensure infection control. To help determine which class a project will be there is a matrix of charts that can be used. With these charts there are a Construction Management 16 Senior Thesis

2 number of steps to determine what class your project is and what precautions must be taken. Step #1: Use Chart #2 to identify the type of construction project activity. Step #2: Use Chart #3 to identify the patient risk groups that will be affected. Step #3: Use Chart #4 to match the type of construction project activity with the patient risk group to find the construction project type. Step#4: Use Chart #5 to determine the required Infection Control precautions by Class. Step #1: Type of Construction Project Activity. Chart #2: Use the following chart to identify the Type of construction Project Activity The Project is a complete renovation. They are replacing both the floor and ceiling tiles. They are also demolishing the walls and construction new ones. They are also installing a new AHU and the ducts that will serve the area. With these activities taking place the Project is a Type C project. Construction Management 17 Senior Thesis

3 Step #2: Patient Risk Group Chart #3: Use the following chart to determine the Patient Risk Group *If more than one risk group will be affected, use the higher risk group. The resource center is renovating an office area. There are no patients located in the area. This makes most of the project a Low Risk Patient Group. However on the first floor where the construction project is taking place is the hospital s Cancer Care Unit where patients are located and treated. Since this area borders one part of the construction project that area of the project is considered a High Risk Patient group. Therefore the project has 2 different risk groups and the higher risk group must be used. Step #3: Construction Project Type Chart #4: Use the following chart to match the type of construction project activity with the patient risk group to find the construction project type. The Project is a Type C project. It also has HIGH Risk Group located next to the one area. If you match these two up in the chart it says the project will be a Class III or Class IV project. Since the High Risk patients are bordering the project and not located in the construction area, the Project was classified as a Class III project. Construction Management 18 Senior Thesis

4 Step #4: Infection Control Precautions Chart #5: Use the following chart to determine the required Infection Controlled precautions. This chart lets you determine the precautions you must take on your construction project depending on what class your project is. Since the is a Class III project there are many projects that must be taken during and after construction. Construction Management 19 Senior Thesis

5 Infection Control Construction Permit For Class III and Class IV projects, the Department of Health must be notified about the details of the renovation. To notify the D.O.H. you must submit an Infection Control Construction Permit (Figure #6) to the Department of Health. It is also required that they come inspect that the proper precautions are taken on the site before construction can start. During this inspection they determine that all required precautions listed in Chart #4 are completed. If all precautions are fulfilled the inspector will sign the permit. This permit must be completed and approved by the D.O.H. before the construction project can begin. Figure #6: The permit that must be submitted to notify the Department of Health of the construction project that will be taking place. Construction Management 20 Senior Thesis

6 Current Phasing Plan Currently the is a 3-phase project. The project is going to have a phased occupancy. When one phase is finished it will be opened up for use by both hospital employees as well as visitors. The renovation is a complete renovation with all the floors, walls, and ceilings being replaced. There is also a new AHU being install, which will serve the area. The air ducts in the area are also being replaced. Phase 1 Phase 1 mainly consists off all the hallways in the area. In this phase the new AHU will also be replace. Most of the work completed in this phase is the ductwork that is running through the hallways. Many of the offices along these hallways will remain occupied by employees of the hospital. Their doors will remain shut to minimize dust spreading into the offices. Phase 2 Phase 2 consists of constructing a new resource center and medical library. This area used to be an old kitchen that served the hospital cafeteria. There are many windows and wood finishes that must be installed during this phase. Phase 3 Phase 3 consists of renovating an existing auditorium as well as the break out area. The main operation taking place in this area is breaking through a wall, which used to be the exterior of the hospital, to create a door into the auditorium. They are also installing a new high tech audio/visual system in the area. As with the resource center area, the auditorium will also have a lot of elegant wood finishes. ICRA There are many steps that must be taken for the entire project in terms of the ICRA requirements. Figure #7: 6-Mil polyethylene sheeting Steps taken during Construction: Remove or isolate HVAC system in area where work is being done to prevent contamination of duct system. o On the resource center project they must cap the ductwork as it passes between a phase that is completed and one that is still under construction. Complete all critical barriers, i.e. sheetrock, plywood, plastic, to seal area from non-work area or implement control cube method (cart with plastic covering and sealed connection to work site with HEPA vacuum for vacuuming prior to exit) before construction begins. Construction Management 21 Senior Thesis

7 o For the project they are using 2 sheets of 6-mil clear polyethylene sheeting, which is run from floor to ceiling and completely sealed around the edges. They must place this barrier around the current phase to completely enclose the construction area (Figure #7). Doors that won t be used must also be sealed with duct tape to ensure that no air-borne particles pass by it. Maintain negative air pressure within work site utilizing HEPA-equipped air filtration units. o The project has CFM HEPA filter exhaust fans, which are run to keep the project at the required negative pressure. Contain construction waste before transport in tightly covered containers. Cover transport receptacles or carts. Tape covering unless solid lid. Steps taken after construction is complete: Do not remove barriers from work area until completed project is inspected by the owner s Safety Department and Infection Control Department and thoroughly cleaned by the owner s Environmental Services Department. Remove barrier materials carefully to minimize spreading of dirt and debris associated with construction. Vacuum work area with HEPA-filtered vacuums. Wet mop area with disinfectant. Remove isolation of HVAC system in areas where work is being performed. Figure #8: Current Phasing Plan Construction Management 22 Senior Thesis

8 Proposed Phasing Plan Phase 1 The main reason for the re-phasing of my project is the ICRA requirements. The proposed phasing plan is a 2-phased project. The first phase will consist of phase 2 of the old phasing plan as well as half of phase 1. This phase of the project contains all areas close to the cancer care unit. This unit will still be a Class III ICRA project and will require all the precautions for that class. Phase 2 This phase of the project contains the auditorium, which is phase-3 of the current plan as well as most of the hallways. It was split up this way because this area has a lower patient risk group. Since the Cancer Care Unit or any other patients are located near this area the Patient Risk group is now a low risk group. If you go back to Chart #3 you can now see that this phase can be classified as a Class II project. This will require fewer precautions to be taken during this phase. Figure #9: Proposed Phasing Plan Construction Management 23 Senior Thesis

9 ICRA The requirements that must be fulfilled during phase 1 of the proposed phasing plan are the same that must be fulfilled during the entire project in the current phasing plan. The advantages for the ICRA requirements are very numerous during phase 2 of the project. Since phase 2 is only a Class II project there are less requirements. With the proposed new phasing plan the ICRA steps must be fulfilled. The two attached floor plans for phase 1 and phase 2 show the ICRA precautions for each phase. Steps taken during construction: Provide active means to prevent airborne dust from dispersing into atmosphere. o The use of 1 sheet of polyethylene sheeting from the floor to the ceiling in various locations will be enough to prevent airborne dust from spreading throughout the hospital. Water mist work surfaces to control dust while cutting. Seal unused doors with duct tape. o Although most of the doors will be in use by employees or visitors there are a few that will be sealed shut with duct tape. Block off and seal air vents. o On the resource center project they must cap the ductwork as it passes between a phase that is completed and one that is still under construction. Place dust mat at entrance and exit of work area Remove or isolate HVAC system in areas where work is being performed. o On the resource center project they must cap the ductwork as it passes between a phase that is completed and one that is still under construction. Steps taken after construction is complete: Wipe work surfaces with disinfectant. Contain construction waste before transport in tightly covered containers. Wet mop and/or vacuum with HEPA-filtered vacuum before leaving work area. Remove isolation of HVAC system in areas where work is being performed. Construction Management 24 Senior Thesis

10 Figure #10: ICRA steps for proposed phase 1 Construction Management 25 Senior Thesis

11 Steps no longer required during phase 2: The airtight barriers around the construction site that are required in a Class III project are no longer required. This will save on both time and money to install and maintain these. The project area doesn t need to be kept at a negative air pressure. The HEPA filter exhaust fans will no longer need to be run for this phase of construction. These fans require constant monitoring. The filters also must be changed frequently depending on the type of activities being performed and how much dust they generate. Figure #11: ICRA steps for proposed phase 2 Construction Management 26 Senior Thesis

12 Advantages There are many advantages that will result from my proposed phasing plan The reduction from 3-phases to 2-phases will reduce the number of inspections that must take place. This is turn will be a result of a schedule reduction. With the ICRA requirements there are a number of inspections that must take place before and after all phases of construction and having them only occur twice instead of 3 times will result in a reduction The current phasing plan has most of the mechanical ducts and piping run during phase 2. This will allow the mechanical contractor to get most of his work done continuously which will be more effective than having him come back during all phases of construction. Although he will still have mechanical work to do in other stages he will get the long duct runs and connecting to the AHU done during one mobilization. The effect on visitor and employee traffic is less extreme. With the current phasing plan all the elevators in the section of the hospital where the construction is taking place will be closed during phase 1. Along with the elevators all of the hallways are also being renovated during the same time. With the new phasing plan at least two of the elevators will be able to stop on the floor of the construction. This will ease the visitor and employee circulation throughout the floor. In the new phasing plan all of the hallways aren t being completed at the same time so the pedestrians will be able to circulate more. When most of the hallways are being complete the project is only a Class II project. In a Class II project the project doesn t have to be completely closed off and people are able to walk through the project, which will allow visitors to continue to use these hallways although they are under construction. This may be detrimental to the workers of the construction project, but minimal disruption to the hospital operations is the number one objective. Construction Management 27 Senior Thesis

13 Cost Comparison The analysis of cost savings is mainly going to focus on the ICRA precautions that must be taken. This cost analysis will also only look into the bigger cost savings items. The new phasing plan will result in small cost savings with the polyethylene sheeting required around the construction site. With the project being reduced from a 3 phase to a 2-phase project, there will be less sheeting to be placed and removed. Also in a Class II project you only need one layer of sheeting and it doesn t need to be maintain and watched as closely as a phase 3 project. The cost of a 10 x 100 of clear polyethylene sheeting costs $ With a 2 million dollar project these material cost savings are very minimal. There will also be saving occurred due to other steps that won t be required. These savings will mainly occur in timesavings due to not having to complete the tasks. These tasks include covering all material before transporting as well as changing the filters in the HEPA exhaust fans. HEPA Vacuums On an ICRA regulated project the site is required to be vacuumed by an HEPA filtered vacuum. Class III projects the construction area is required to be vacuumed daily. Class II projects the construction area is only required to be vacuumed at the completion. The HEPA vacuum used on this project is a 55-galloon wet/dry vacuum. The rental costs of these vacuums are: Figure #8: HEPA filter exhaust fan Daily...$36 Weekly..... $108 Monthly $325 HEPA Filter Exhaust Fans A class III ICRA project requires the project to be kept at negative pressure throughout the construction project. On the resource center project this is done using 2 HEPA Filter Exhaust Fans. These fans are 2000 CFM units. The rental cost for these units are $450/month each plus the cost of the pre filter and HEPA filter. The cost of a pre-filter is $30/each. The cost of a HEPA filter is $180/each. Construction Management 28 Senior Thesis

14 Depending on the demo/type of project that is being done the filters get changed out often. It is hard to estimate per job the change out schedules. For this cost analysis I estimated they would get changed once per week. Chart #6: Cost comparison for the ICRA precautions. Total Current Phasing Plan.. $30,310 Total Proposed Phasing Plan...$9663 Total ICRA Savings with Proposed Plan..$20,647 These cost savings by changing phase 2 to a Class II project are very significant. Most of these savings are occurred because the HEPA filter exhaust fans are no longer needed. It is a major cost to keep the project at a negative pressure. Construction Management 29 Senior Thesis

15 Schedule Comparison This comparison is going to look into the timesavings of reducing the project from a 3- phase project to a 2-phase project. There are a lot of extra steps that must be completed during an ICRA regulated job. These steps add duration onto the project length Each phase requires Temporary Protection and ICRA requirements to be set up. o This setup is 5 days in length for each phase to be started. Each phase requires inspections by the hospital before construction can begin o The hospital inspections duration is 2 days. Each phase requires inspections by the Department of Health to ensure ICRA precautions before construction can begin. o These inspections take a day to complete The D.O.H must also inspect the project after a phase is complete and the area must be turned over to the owner o This inspection and owner turnover takes 1 day. Each phase also requires a thorough cleanup at the end of each phase to prepare for the D.O.H. inspections. During this cleanup time no work can be completed. o The final cleaning depends on the size and type of work taking place in the phase. Construction Management 30 Senior Thesis

16 Figure #9: Current Schedule. Construction Management 31 Senior Thesis

17 Figure #9: Current Schedule (cont d). Construction Management 32 Senior Thesis

18 Figure #10: New phasing plan schedule. Construction Management 33 Senior Thesis

19 Figure #10: New phasing plan schedule (cont d). Construction Management 34 Senior Thesis

20 Total duration during each phase for ICRA regulations Temporary Protection.5 days Hospital Inspection 2 days D.O.H. Inspection before construction.. 1 day DOH Inspection after completion.. 1 day Phase Cleanup 3 days Total Time Saved. 12 days The time saved due to reducing the number of phases from 3 to 2 is over 2 workweeks. Since this project is only an 8-month project this schedule reduction is very significant. This timesaving of 2 weeks will also result in a cost savings for the general conditions. The general conditions total cost is $132,824 without the ICRA equipment and precautions included. I am not including these in this cost savings because the cost savings of them is already discussed in the previous section. The general conditions can be broken down into a weekly cost of $3090/week. The cost savings of this reduction will then be $6180. Construction Management 35 Senior Thesis

21 Additional Reduction The new proposed schedule also includes more schedule reduction. The current project schedule has a completion date of August 27 th 2004 The proposed project schedule has a completion date of July 29 th 2004 With these two dates the project schedule also has been reduced by an extra 9 days above the ICRA savings. This reduction is due to the changing of the critical path. The areas of the hospital are now included in different phase, which cause the critical path to change for the better. These savings are not as guaranteed due to the uncertainty of the percentages of work completed in each stage. I have just estimated the amount of work that will be done in each stage from the drawing and the current schedule. Although these are certain there is a strong possibility that some of this reduction will be realized. Timesavings might also occur due to the fact that contractors will only have to mobilize 2 times instead of 3 times. They will be able to increase the amount of work done each time they are on site, which will result in better productivity and possibly a schedule reduction. Recommendation My recommendation for the project is to adopt the proposed phasing plan. The new plan realized both a cost and schedule reduction. The total cost savings are $26,827, which includes the savings from both the ICRA precautions as well as the schedule reduction. The schedule reduction solely due to the decrease in the amount of inspections and ICRA steps is 12 days. Cost Savings.. $26,827 Schedule Reduction Days Although there is both a cost savings and schedule reduction with the proposed phasing plan there are other issues that may cause this phasing plan not to work. One of the main issues is the hospital operations. Switching the time frame that the different areas will be able to be occupied may conflict with the hospital operations. The auditorium is used often by the hospital for presentations and guest speakers. Since some of the people that are speaking come in from all over the world their schedule must be adhered too. Another issue with my proposed phasing plan is the two different classes of phases. To allow one phase to be a Class III, while the other is a Class II they have to be submitted as two separate construction projects. This requires more paperwork to be submitted to the D.O.H. as well as many other organizations and companies. Construction Management 36 Senior Thesis